A Top Cardiologist Explains How to Give Your Heart a Tuneup

Preventing coronary heart disease can be as easy as changing your diet and adding heart-healthy exercise. In this exclusive interview, a top cardiologist explains the importance of a heart tuneup and offers tips to do it…

Most people are diligent about getting their car a tuneup at least yearly. Cleaning the filters and replacing fluids get auto engines purring again. Yet many women don’t tune up their hearts to prevent coronary heart disease.

“You wouldn’t put chips and junk food in your gas tank, but people do that to their bodies all the time,” says Steven Masley, M.D., a St. Petersburg, Fla., physician, nutritionist and heart researcher and author of The 30-Day Heart Tune-Up (Center Street, 2014).

“You can replace a car,” he adds. “Hearts aren’t as easy.”

Statistics prove that: Coronary heart disease (CHD) is the most common heart problem in the U.S., and the No. 1 killer of women and men.

With CHD, plaque – a sticky, fatty substance – builds up on the inner walls of heart arteries, which can lead to a heart attack.

Fortunately, you can prevent coronary heart disease with lifestyle changes, such as eating healthfully, reducing stress and exercising regularly.

In this exclusive Lifescript interview, Dr. Masley explains why a heart tuneup is so important and which tools work best.

With so much information available about preventing coronary heart disease, why do women still put heart health low on their to-do lists?
There is quite a bit of denial and misinformation about heart disease. There are also many competing heart-healthy diet plans. People are confused, so they think, I’ll do what the heck I want.

At some point, you have to use common sense: Eat healthy proteins, healthy carbs and food that’s nutritious and tastes good.

What are the top cardiovascular risk factors? High blood pressure: It’s not just a risk factor, it’s also a measure of your arteries’ health. Uncontrolled high blood pressure can kill you because you don’t always know you have it. It can cause a stroke, kidney damage and other serious health problems.

Lack of fitness. That includes strength-training [building muscle mass], stretching for flexibility and aerobics. Our lifestyles are so different than those of earlier generations. Americans were much more active 30 to 40 years ago. And today we sit a lot more.

Is family history a heart disease risk factor, and can a heart tuneup help prevent it? Your genetic makeup contributes about 10% to your risk of death from heart disease. The other 90% risk is environmental, such as the toxins you eat and your stress level.

But we can prevent and reverse plaque buildup. Hundreds of my patients have shrunk plaque in their arteries through lifestyle changes.

In your book, you discuss the heart’s “literal age.” What does that mean?
Measuring the literal age of a person’s cardiovascular system is much more important than measuring other cardiac risk factors. The thicker your arteries, the “older” they are. You could be 40 and have 50-year-old arteries.

It must be done under a doctor’s supervision. I recommend that carotid IMT scores be checked at least once in your lifetime.

Also, a chest CT scan allows me to see old calcium in the arteries. I have patients do this every two years and I can tell if an artery is growing, shrinking or staying the same.

[Editor’s note: IMT measures the thickness of the inner two layers of the carotid artery. It alerts physicians to thickening before patients become symptomatic. Then your doctor can more aggressively manage your risk factors.

A CT, or computed tomography, scan combines a series of X-ray views and angles to get a clear view of your organs.]

Aren’t cholesterol levels the main indicator of future heart problems?
Let’s look at total cholesterol. Would you take all your debt and savings, add them together and call the sum a meaningful number? That makes no sense!

So why add up total cholesterol, when there’s good and bad cholesterol?

If you eat junk, your arteries get clogged with LDL (low-density lipoprotein or “bad cholesterol”); it adds to arterial plaque. One type of LDL, though – large, puffy LDL particles – is not dangerous.

One type of HDL (high-density lipoprotein or “good cholesterol”), called HDL2, is effective in hauling away the garbage in the arteries. But HDL3 isn’t. So you may have a good HDL score, but it may not be protective against heart disease.

Traditional total LDL and HDL cholesterol markers are accurate 80% of the time, but you can’t fully rely on them to determine your heart health.

How can patients get a true reading of their heart attack risk?
If you’re at high risk or have a worrisome family history of cardiovascular disease, an advanced lipid profile will dig deeper. [So ask your doctor for tests] checking your HDL2 and HDL3 cholesterol, your LDL cholesterol and normal cholesterol levels.

Are statins effective in preventing heart disease in women?
Unless a woman has known heart disease, statins are ineffective in most cases. They’re far less effective than lifestyle changes in shrinking plaque.

Lifestyle changes include eating heart-friendly foods, building your fitness levels and managing stress. While statins are good for those who’ve had a heart attack, I exercise caution before prescribing them, to avoid side effects, such as liver damage, and because they don’t help most women.

Which heart-healthy foods should women eat?

Olive, nut and avocado oils

All kinds of nuts

Seafood, especially those with omega-3 fatty acids (salmon is the best)

Why is fiber so important to prevent coronary heart disease? I conducted a study at my clinic, which found that most patients get only one-third of the fiber they need. They’re also deficient in vitamins D and K, and potassium. It’s no wonder they’re wrecks!

Fiber lowers cholesterol, improves blood sugar and makes you feel full and satisfied so you lose weight. It has hundreds of anti-aging compounds.

Fruit, vegetables, nuts and beans are the best sources. You get a little from quinoa and wild rice too.

What’s the best type of heart-healthy exercise? I recommend aerobics, muscle-strengthening and stretching. To find out how fit you are, do aerobic and strength testing with a trainer, if possible.

If you’re muscular, but not aerobically fit, do aerobic exercises, such as biking, walking or swimming. You have to customize your exercise to your fitness level.

You don’t need a gym either. Burn fat and get a good workout from dancing, walking the dog or yardwork. Pick an activity you like doing 4 to 5 days a week.

What do you recommend if a woman is thin, doing heart-healthy exercise and eating fiber, but still has arterial plaque and high cholesterol? In that case, I talk about putting her on medication such as statins.

Which foods should women avoid to prevent coronary heart disease? Sugar and trans-fats are huge toxins, and 30% of calories in American diets come from toxins. Trans-fat is like liquid plastic injected into food – eat it and you’re poisoning yourself.

[Editor’s note: Trans-fats are found in pies and pie crusts, stick margarines, shortening, and many fried and baked goods. Although some trans-fats occur naturally in foods, most are industrially manufactured. If you see “partially hydrogenated oils” on the ingredient list, the food contains trans-fats.]

How does intimacy improve women’s heart health?
Human touch, connection, intimacy and love are calming and reduce stress. It’s like plugging our electrical cord into an outlet and recharging. Sex also releases oxytocin from the brain; it helps relieve stress, which is good for your heart.

Sexual receptiveness has a lot to do with circulation. These foods help your circulation:

Protein: shrimp, turkey, game meat, chicken – free-range and organic.

Foods with zinc, such as oysters, pumpkin and chocolate, which you should enjoy in limited amounts, about 1 square of dark chocolate per day.

Beets are vasodilators, which widen blood vessels.

In addition to sex, how can women dial back the stress and relax?
Get a good night’s sleep. Way too often, women don’t.

Limit stimulants to one glass of wine with dinner and one cup of coffee each day.

What can women with autoimmune diseases, such as RA and lupus, do to tune up their hearts?
Inflammation and autoimmune diseases [go hand in hand]. A top drug used to treat inflammation – prednisone – increases blood sugar levels and arterial plaque growth.

Women with autoimmune diseases who exercise and cut out junk and toxins can put themselves in remission. I’ve had many patients with autoimmune diseases who improved their lifestyles and were able to wean themselves off medications.

Should older women take a daily low-dose aspirin to prevent coronary heart disease?
They work for women sometimes. Aspirin often affects a woman’s gastrointestinal (GI) tract: You can have a stroke and GI bleeding.

If you’re at high risk for heart disease, though, there is more benefit than risk if you take aspirin.

Is it OK to get off the health wagon occasionally?
Take good care of yourself 80% of time. Once in awhile, have some fun.

The goal is to be in good health most of the time so you don’t have to worry about it. You can have cake on your birthday.

Are You on the Road to a Heart Attack?
Coronary heart disease, the leading cause of death in this country, contributes to the 1.5 million heart attacks that occur each year. Will you become a part of this statistic? Learn more about heart attack symptoms and find out if your ticker is going to keep ticking with this heart attack quiz.

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